Health problems in our nation?s communities are not uniformly distributed. While the national infant mortality average is 7.2 deaths per 1,000 live births, the highest prevalence when categorized by race is among African American infants. The African American infant mortality rate is 13.8 nearly three times higher than the racial group with the lowest infant mortality rate. Medical advances alone have not eliminated the health disparity gap implying that social and psychological constructs also play important roles. The goal of this research proposal is to study the effects of stress and coping on birth outcomes. The specific aim is to gain a better understanding of how perceived racism and stressful life events affect the birth outcomes of African American women and to describe how coping, including spirituality and social support, are related to the cumulative stressors that these women experience. Data will be collected from interviews during pregnancy using various tools to measure stressful experiences that women may encounter and coping strategies used in their lives. Each study participant will be tracked to identify birth outcome. Racial health disparities are a complex issue. This proposal will add a dimension to existing knowledge by examining perceived experiences of racism in context with other variables and their effects on birth outcomes among African American women.